老年慢性心力衰竭患者心电图碎裂QRS波群与主要心血管不良事件的关系

Correlation between electrocardiographic fragmented QRS complex and major adverse cardiovascular events in elderly patients with chronic heart failure

目的探讨老年慢性心力衰竭患者心电图碎裂QRS波群(f QRS)与主要不良心血管事件(MACE)的关系。方法选择2014年9月至2016年9月义乌復元医院收治的老年慢性心力衰竭患者190例,按照心电图分为f QRS组(n=60例)及非f QRS组(n=130例),收集临床资料及随访12个月发生MACE情况。结果 f QRS组美国纽约心脏病协会分级、血清B型脑钠肽、血清尿酸水平高于非f QRS组,而左心室射血分数低于非f QRS组,两组比较差异有统计学意义(P均<0.05);f QRS组MACE发生率高于非f QRS组(41.7%vs 25.4%,χ~2=5.132,P<0.05);Ka p la n-Me ie r生存曲线显示f QRS组发生MACE的风险显著高于非f QRS组,比较具有统计学意义(P<0.01)。多因素Cox回归模型显示,f QRS是老年慢性心力衰竭患者发生MACE的独立预测因子(HR=1.757,95%CI:1.250～2.253,P<0.05)。结论心电图f QRS的老年慢性心力衰竭患发生MACE的风险增加。

Objective To explore the correlation between fragmented QRS complex(fQRS)and major adverse cardiovascular events(MACE)in elderly patients with chronic heart failure(CHF).Methods 190 cases of elderly inpatients with CHF were enrolled from September 2014 to September 2016.They were divided into fQRS group(n=60 cases)and non-fQRS group(n=130 cases)according to electrocardiogram.General clinical information and MACE occurred during follow-up 12 months were collected.Results New York heart association classification,serum brain natriuretic peptide,uric acid levels were significantly higher,and left ventricular ejection fraction was significantly lower in fQRS group than in non-fQRS group(P<0.05).MACE occurred significantly more in fQRS group than in non-fQRS group(41.7%vs 25.4%,χ^2=5.132,P<0.05).Kaplan Meier survival curve showed that the risk of MACE in fQRS group was significantly higher than non-fQRS group(P<0.01).Multivariate Cox regression model showed that fQRS was an independent predictor of MACE in elderly patients with CHF(HR=1.757,95%CI:1.250-2.253,P<0.05).Conclusion The risk of MACE increases in elderly CHF patients with fQRS on electrocardiogram.